Prenatal Exposure to Ambient PM and Early Childhood Growth Impairment Risk in East Africa.

Height for age is an important and widely used population-level indicator of children's health. Morbidity trends show that stunting in young children is a significant public health concern. Recent studies point to environmental factors as an understudied area of child growth failure in Africa. Data on child measurements of height-for-age and confounders were obtained from fifteen waves of the Demographic and Health Surveys (DHS) for six countries in East Africa. Monthly ambient PM concentration data was retrieved from the Atmospheric Composition Analysis Group (ACAG) global surface PM estimates and spatially integrated with DHS data. Generalized additive models with linear and logistic regression were used to estimate the exposure-response relationship between prenatal PM and height-for-age and stunting among children under five in East Africa (EA). Fully adjusted models showed that for each 10 µg/m increase in PM concentration there is a 0.069 (CI: 0.097, 0.041) standard deviation decrease in height-for-age and 9% higher odds of being stunted. Our study identified ambient PM as an environmental risk factor for lower height-for-age among young children in EA. This underscores the need to address emissions of harmful air pollutants in EA as adverse health effects are attributable to ambient PM air pollution.